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Norfolk and Suffolk Wellbeing Services
From an IAPT service to a broader
Wellbeing Service in Norfolk and Suffolk
– Challenges and Opportunities
Nesta Reeve
Consultant Clinical Psychologist/
Clinical Lead for Norfolk and Suffolk Wellbeing Services
Friday 22nd March, Leicester
Norfolk and Suffolk Wellbeing Services
Norfolk and Suffolk Wellbeing Services
Benefits of IAPT in Norfolk and Suffolk
• Mind the gap - Significant expansion in provision of psychological approaches to those with mild to moderate anxiety and depression
• Excellent career development opportunities of trainings as CBT therapists and PWPs
• Raised the profile of the impact of offering earlier access to psychological interventions
• Opportunities to help those with mild/moderate depression/anxiety to get back into employment
Norfolk and Suffolk Wellbeing Services
• Provision of high level of governance and supervision standards for psychological interventions
• Systematic national reporting of outcomes to measure impact
• Cultural challenge of encouraging self-referral
• Culture of high volume brief interventions
• Opportunities to develop integrated services (e.g. with counselling, employment support)
Norfolk and Suffolk Wellbeing Services
Challenges of IAPT
• Challenge of predominant medical model: diagnoses, symptoms focused
• Outcome measures for ‘recovery’ emphasise symptom change vs functional improvement
• Limitations of expecting minimum 50% of people moving from ‘caseness’ to ‘non-caseness’ as measure of success of service
• Rigidity of protocol driven approach
Norfolk and Suffolk Wellbeing Services
• Target of 15% access, but of those who can ‘recover’ –
discourages access for all
• Discouragement for services to operate full stepped care
– likeliness of IAPT services to avoid potential step 4
cases in case they need stepping up (as for IAPT this is
non recovered).
Norfolk and Suffolk Wellbeing Services
Why Wellbeing matters to Norfolk and Suffolk
Definition of wellbeing:
‘Positive mental health or mental wellbeing is more than simply the absence of mental illness.
Mental wellbeing means that an individual is able to realise his or her own abilities, cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution
to his or her community’
from Commissioning Mental Wellbeing (2010)
Norfolk and Suffolk Wellbeing Services
The effect of shifting the mean of the mental health
spectrum
Flourishing Moderate
mental health Languishing
Mental disorder
From: Huppert Ch.12 in Huppert et
al. (Eds) The Science of Well-being
Norfolk and Suffolk Wellbeing Services
National guidance for commissioners
• No health without mental health (Feb 2011) etc.
Strategy to:
– Improve the mental health and wellbeing of the
population
– Keep people well; and
– Ensure more people with mental health problems
regain a full quality of life as quickly as possible
Norfolk and Suffolk Wellbeing Services
How to provide wellbeing service including IAPT
• Both wellbeing approaches and IAPT are important!
• Integrated service model - IAPT and other wellbeing approaches
• Strong partnership working
• Separating IAPT/non IAPT wellbeing approaches for reporting
• Encouraging peer led support, self selected steps to improved wellbeing, varied approaches to meet varied needs of population
• Working with communities as well as individuals to promote wellbeing
• Evidencing impact of Wellbeing approaches Trialling use of WEMWBS for wellbeing approaches
• Thinking creatively
Norfolk and Suffolk Wellbeing Services
Stress Campaign
Norfolk and Suffolk Wellbeing Services
Nesta Reeve
Clinical Lead for Norfolk and Suffolk Wellbeing Services
07825 792299
